Department of the Inteeiok
BauFAO OP Health
History and Description
« -a »
. 1900 to 1911
lOHN E. SNODGRASS, M.'D,
uo-der the directioh of
the Aclhig Director of. Heaith
DR. CARROLL FOX
BlIEEAU OF PRINTING
'•♦(•• • '..II
on Sot;' ii
|| Cornell University
The original of tiiis book is in
tine Cornell University Library.
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the United States on the use of the text.
Department of the Interior
Bureau of Health
History and Description '
1900 to 1911
JOHN E. SNODGRASS, M. D.
under the direction of
the Acting Director of Health
DR. CARROLL FOX
BUREAU OF PRINTING
In writing a history of the magnificent new hospital which now
adorns Taft Avenue, Manila, it is proper to state, at the outset,
that a lion's share of the credit for its erection is due the
Honorable Dean C. Worcester, Secretary of the Interior, as it
is extremely doubtful whether the hospital, in its present propor-
tions and grandeur at least, could have been built without his
unflagging interest and tenacity of purpose.
As a result of ten years of hard work and persistent effort on
the part of Government officials and laity, Manila possesses a
hospital which compares favorably with the best hospitals of the
world and which is already proving a veritable godsend to the
people of the Islands. Although it has been in operation only
a short time it is apparent that more space will be required in
the near future. Applicants for admission have to be turned
away almost daily. The fact that the Filipinos are clamoring for
more room clearly indicates that the right note has been struck,
and that the hospital is going to prove of incalculable and lasting
benefit to the Philippines.
Many other persons deserve special credit for their efforts
toward the building of the hospital. More prominent among
these are President Taft, Governor-General Forbes, Dr. J. R.
McDill, former Commissioner of Health Major E. C. Carter, and
the present Director of Health Dr. Victor G. Heiser.
Much difficulty has been experienced in collecting the necessary
facts and data for this publication and the writer wishes to make
acknowledgment of the material assistance rendered by the
acting superintendent of the hospital, Mr. Newton C. Comfort, the
chief accountant of the Bureau of Public Works, Mr. J. Pickering,
the acting chief of building maintenance. Bureau of Public Works,
Mr. Lewis Cook, and others who took part in the building of the
hospital or are at present connected with the management of the
John E. Snodgrass,
Bureau of Health.
Manila, P. I., October 1,1911.
HISTORY AND DESCRIPTION OF THE PHILIP-
PINE GENERAL HOSPITAL.
In the year 1900, prior to the establishment of the Civil Gov-
ernment in the Philippine Islands, and shortly after the arrival
on the ground of the Second Philippine Commission, commonly
known as the "Taft Commission," Dean C. Worcester, who was
then a member of the Commission and who had held the position
of Secretary of the Interior since the establishment of the Execu-
tive Departments of the Insular Government, formulated a plan
for the establishment in Manila of Central Government labora-
tories for the performance of routine work and original scientific
research, of a medical college, and of a General Hospital, all to
be located as near each other as practicable, upon a lot large
enough to provide for all probable future expansion, the three
institutions to be so interrelated that the Government laboratories
might do routine work for the hospital and at the same time carry
on original research relative to the causation and relief of disease,
utilizing for the latter purpose material furnished by the hospital ;
that the laboratory staff might be available for teaching in the
medical school and for service in the hospital ; that the students
of the medical school might have abundant opportunity for
practical instruction in the hospital wards and clinics; and that
the members of the teaching staff of the medical college might
have opportunity not only to aid in the hospital work but to carry
on their own original investigations in the laboratory.
The realization of this project seemed so improbable that its
originator was called "crazy," while the plan itself was commonly
designated as "Worcester's dream." The first step toward its
realization was taken when the Bureau of Government Labo-
ratories was established on July 1, 1901, by the passage of an
act which provided for the centralization of all the biological and
chemical work of the Insular Government. A further and great
advance was made when the Philippine Bureau of Science, into
which the Bureau of Government Laboratories ultimately devel-
oped, occupied the carefully planned and well equipped laboratory
building constructed for its special use. This building was
erected on the so-called Exposition Grounds which afforded a
conveniently situated site of sufficient size to accommodate all
of the buildings needful for a medical school and for a hospital
of a thousand or more beds, but at the outset other plans were
entertained relative to the future of that portion of the land in
this tract not needed by the Bureau of Science, and it was only
after a long and determined contest that its reservation for a
hospital and a medical school was secured. Then followed the
establishment of the medical school itself, which was provided
for by a law enacted on December 1, 1905. The school was at
first, of necessity, given temporary quarters pending the construc-
tion of a suitable home for it. The medical school building, which
stands on the Exposition Grounds immediately to the west of the
building of the Bureau of Science, was occupied on June 1, 1910.
The completion and occupation of the splendid group of rein-
forced concrete buildings which now constitute the Philippine
General Hospital marked the full realization of "Worcester's
President Taft, the first American Civil Governor of the Phil-
ippine Islands, favored this project from the start. On Novem-
ber 30, 1907, immediately after a visit to the Philippines, he
wrote Secretary Worcester as follows:
My own impression is that it would be much better if the Medical School
were included in your Department of Sanitation. There, I think, is where
it properly belongs, and as you have the laboratory and will have the hos-
pital, it seems to me that the school should be under the same head. There
is not the slightest reason why it should be embraced in the Education
Department. I regard the school as of the highest importance in the devel-
opment of the Philippines and to furnish to the inhabitants a basis for
more reasonable living and great physical development. I don't think that
there is anything that we have on hand more important than to develop the
Filipinos physically. I know it can be done if the improvements in the
water supply, and in food, and in proper hygiene can be given proper appli-
cation. The school, therefore, in spreading an evangel of decent, healthful
living through its graduates is more of a sanitary than it is of an educa-
tional character. // / could visit the Philippines again in two years, I
should hope to see your hospital and your medical school and your labora-
tory all running close together, and that ideaf which you have painted in
words so often in the Commission will then be realized.
Secretary Worcester has never sought to gain control of the
College of Medicine and Surgery, which to-day forms an integral
part of the Philippine University, but has successfully endeavored
to bring about a practical working relationship between this
college, the Bureau of Science, and the Philippine General Hos-
pital, such that these three institutions might mutually assist
each other and might constitute an ideal combination for the
investigation and the combating of disease. Were President Taft
to visit the Philippines to-day, he would see the Medical School,
OLD CIVIL HOSPITAL.
OLD LABORATORY BUILDING.
BUREAU OF SCIENCE.
COLLEGE OF MEDICINE AND SURGERY.
the Hospital, and the Laboratory running "close together," not
only in geographic situation but in harmony and community of
It is with the history of the General Hospital that the writer
is chiefly concerned. President Taft's interest in this great
hospital is by no means of recent date. While President of the
Philippine Commission, and prior to his appointment as Civil
Governor of the Philippines, he requested Maj. John R. McDill,
U. S. v., to present recommendations looking toward the estab-
lishment of a General Hospital in Manila. The report of Major
McDill made in reply to this request follows :
First Reserve Hospital,
Manila, P. I.
November 12th, 1900.
To the Honorable Wm. H. Taft,
President Civil Commission, Philippine Islands, Manila, P. I.
Sir: In compliance with your request I have the honor to make recom-
mendations based upon the following brief statements concerning a general
hospital for Manila, P. I.
The most useful hospitals are general ones, built upon the pavilion plan,
with ample acreage and good management, under competent medical direc-
tion. It should combine a school of instruction for male and female nurses;
the material should be accessible, under proper restrictions, to students of
medicine and it should be a center for the scientific investigation of disease.
In the present state of our knowledge of hospital construction, hygiene and
the true principles of health such a hospital could be made a blessing and
a benefit to rich and poor, as well as a safeguard and defense to the public
health. The broad general object of hospitals may be stated to be the
gratuitous medical and surgical treatment of indigent sick. There is a
large class, however, above the very poor who are but ill able to afford
skilled attendance and nursing at their homes. It is not desirable, nor is
it always their own wish that these persons should be objects of charity
and the establishment of paying departments meet this difflculty to some
extent; However, if it is accomplished it should be done with fairness to
other hospitals and to all concerned, and paying patients should have the
medical man of their choice, and every physician should be, as far as his
patient is concerned, in such a hospital a free, independent, responsible
agent, enjoying equal rights with all as far as consistent with wise manage-
ment. A cardinal principle to be observed in such a hospital is that it shall
do as little harm as possible. There is always a certain danger of pro-
moting in free hospitals negligence, shiftlessness, laziness, and vice by
offering free relief from their consequences. This is a" danger connected
with the management and can be guarded against.
The only differences to be considered in constructing a hospital in Manila
and one elsewhere are connected with the climate' and classes of disease
encountered.' The construction is vastly simpler here than in temperate
climes; the great subject of heating and artificial ventilation and their
attendant expenses do not figure here at all. The provision in a general
hospital for Manila against infectious diseases is primarily a defensive
measure and demands immediate and most serious consideration. Means
must be provided of isolating at once the earliest cases of epidemic disease.
Hours could be occupied in relating instances in which epidemics have
evidently been prevented by the isolation of first cases of infectious disease.
The necessity of these sanitary defenses is, therefore, exceedingly clear.
A hospital built in these days and under the direction of your commission
which is so absolutely free from local political influences should have fewer
objections to its plan than any Government hospital hitherto constructed;
by avoidance of objects of expedience, of cheapness, or ornament and erected
with the design of subserving all the interests of modern scientific achieve-
ments as well as the interests of patients and physicians.
The controlling idea in founding such institutions, unhampered by any
misapplied notions of benevolence or necessity of economy should be the
practical application of sanitary science in treating the sick; as it is well
known that absurd and mistaken economy has often rendered pious labor
and expense in a great measure not only useless but even fatal and destruc-
tive to its very aim and endi
SYSTEM OP BUILDING.
Of the two systems of building to choose from only the pavilion can be
considered. This is the arrangement of a number of buildings, in which
wards, administration, attendance, help, kitchens, and various parts of the
economy are separated. This is in antithesis or contrast to the corridor
system, a system of decentralization of the individual parts of a hospital.
ESTIMATE OF NUMBER NEEDING HOSPITAL CAKE.
A question of primary importance to you is, how many beds are re-
quired. To the consideration of this subject can be brought experience
concerning the general relation of the number of sick to the population
of various places, as modified by the situation of the hospital and the
climatic conditions; further, the principal occupations and general health
conditions of a city's inhabitants, as well as the proximity of other institu-
tions for the sick and many local factors. Not the least of these is that
future management and arrangements of a hospital, to be founded now,
can and should be such as to inspire confidence in the people as to its
great necessity and benefit to health and thereby cause it to be used by
all classes in time of sickness.
As far as this general experience is concerned. Plage estimated upon
the basis of Husson's investigations that, according to the number of sick
received in the Parisian hospitals and the number of days spent by the
sick in hospital, for each one thousand inhabitants about five beds were
used. Essentially less is the calculation by Douglas C. Galton on the
general hospitals of London, exclusive, of course, of hospitals for infec-
tious disease, which is about one bed to one thousand inhabitants. This last
proportion, for general and surgical cases, Galton, in conformity with
the view of Burdett, Waring, and others, says can be regarded as the
standard sick bed necessity of English municipalities. In addition, Bur-
dett insists that for districts with mines, great shops and the like, four to
five beds for each one thousand people should be provided. Oppert finds
that for large cities with extensive poor districts about four beds per
thousand are needed. According to a computation on the basis of the
statements of the statistical "Jahrbuch" of German cities, Hamburg in
1890 used for each one thousand inhabitants about five beds, this included
all of the general hospitals for every purpose. Berlin used about four
beds, Cologne five and seven-tenths, Stuttgart six beds, Potsdam six and
eight-tenths beds, Breslau four beds, and Dresden three and three-tenths
beds. Therefore, for large cities space for hospital accommodations of at
least five beds to each one thousand inhabitants should be provided, es-
pecially as hospitals are in these times far better understood and appreci-
ated and far more taken advantage of than formerly.
Thus far it is assumed that these estimates were entirely based on the
use made of hospitals by the poorer classes. Should paying patients be
admitted the beds for such are to be provided in addition.
In deciding the extent of area of a new hospital it is necessary to
consider not only the present need, but there must be a certain reserve
space, which future increase in population will require, as well so as to
be prepared for special emergencies, like epidemics and great disasters
from storms, floods, or fire.
SIZE OF A HOSPITAL.
Although many authorities have laid it down that no hospital should
house more than five hundred patients, the great example of the "Hamburg-
Eppendorf" pavilion hospital of fifteen hundred beds, where every detail
of administration, service, and of attention to hygiene is carried out to
perfection, shows the possibilities of modern methods and science in hos-
pital construction, organization, and management.
SIZE, LOCATION AND NATURE OF A HOSPITAL SITE OK GROUND AREA.
Primary requisites; pure and fresh air; sufficient elevation for drainage;
pure soil; accessibility by water and wheel transportation, and for pavilion
hospitals about 100 square meters (120 square yards) per bed for a
hospital of one hundred beds.
This surface area should increase with the number of beds until a 600-
bed hospital would have about 150 square meters per bed, or namely
fifty beds to the acre. One acre equals about 4,050 square meters.
Infection hospitals need a greater area or thirty to forty beds to the
The average ground area of the following-named hospitals of a total
of 6,370 beds is 132 square meters. Square
Hamburg-Eppendorf 1,500.... 124
Friedrichshian 784.... 122
Heidelberg 360.... 110
Ruldolfspital, Wien 800.... 43
Lariboisiere, Paris 612.... 82
St. Louis, Paris 700.... 130
Montpellier 600.... 150
Zurich 500.... 160
Kopenhagen 312.... 280
Johns Hopkins 400.... 140
The Kinderspital of Moskau of 180 beds has an average ground area
of 782 square meters per bed.
When sites of general hospitals are too distant from the center of
population for the transport of emergency or cases needing immediate
care, a most desirable and necessary adjunct is a centrally located emer-
gency hospital. ,
As before stated, there should be discussed here only a general pavilion
hospital with a department, either on the general same site or remote, for
Incurables, the insane, lepers, and pulmonary tuberculosis should be cared
for in separate institutions, in special localities.
By a general hospital is meant one with departments for all medical,
surgical, and lying-in, eye and ear, and children's diseases.
1. A building should be set aside for the nurses on duty and under
2. A building for clinical instruction of students of medicine is one of
the obligations of every modern public hospital.
3. In the disposition of the space the sick must be grouped by separation
of the sexes and then further according to the nature of the diseases.
4. When paying patients are to be admitted their buildings should lie
5. A two-story or corridor building might be found desirable for the
segregation of syphilis, venereal and contagious skin diseases which are
usually separated from the main body of a hospital more on disciplinary
than medical grounds.
Each general hospital, aside from the contagious department, divides
into two principal sections — surgical and medical.
This allows of the most convenient grounding of buildings and of the
arrangement for the best care of the sick and the best work of the medical
Accordingly the following chief grouping of the sick and their separation
in the building program must be kept in view :
1. Surgical Department including eye and ear, gynecology, and so forth.
2. Medical Department.
3. Obstetrical Department.
4. Department for acute infectious disease as scarlet fever, measles,
mumps, typhus, cholera, smallpox, plague, pyaemia, 'erysipelas, diphtheria,
and hospital gangrene.
It is very difficult to determine even approximately the number of beds
required for each group of diseases which fluctuates so markedly. Plage
has, however, arranged a procentum scale for a 300-bed hospital which as
applied to Germany and the continent is instructive.
Each large general hospital should have a detention house for acute
manias, violent delirium tremens, objects of disgust, as sexual perverts and
The capacity of ward buildings should range from four to sixty beds
each. Each ward should have one or more separate or private rooms, a day
room, bath, closets, etc.
Every detail of construction, furnishing and arrangement of buildings
one to the other can be now planned before hand so that plans and specifica-
tions can be drawn upon which a contract can be let that will not need
any important alteration or change.
THE ISOLATION HOSPITAL OR DEPARTMENT.
Of supreme importance is the pathological laboratory and experiment
station for the scientific investigation of contagious and epidemic disease,
as the chief feature of the isolation hospital. The necessity of isolation
hospitals for contagious disease and which are primarily defensive, is too
absolute to require argument. With a favorable and accessible site of
suflncient area, the question of cost of barrack and tent hospitals for great
emergencies can be briefly dismissed as being about one-fourth that of a
permanent hospital. The pathological institute, however, and its wards
to accommodate about 100 beds should be permanent structures. Such an
arrangement of an isolation hospital combined with a perfectly equipped
bacteriological and pathological laboratory and observation wards would be
one of the most important in the world and could benefit mankind as has
the celebrated Koch Institute of Berlin, established by the German Govern-
ment and the Kitasato Laboratory of the University of Japan.
In a coast city like Manila, exposed to epidemic disease, there should be
preparation always to furnish without much delay floating river or harbor
hospitals in addition to the above accommodations.
COST OP SUBSISTENCE AND RUNNING EXPENSES.
Subsistence of native patients and native employees it is thought would
not cost above 20 cents gold per day. The pay of attendants and employees,
who should be mostly natives, is about one-half that in America or Euro-
pean countries or even that of the enlisted men of the Hospital Corps
in the United States Army.
Competent medical and administrative officers will cost as much or
more than paid by the army or civil institutions at home.
Once a medical college is established by the Government the graduates
can be used as assistants and they are glad to serve one year for the
experience. Such positions are obtained by competitive examinations and
are highly prized.
It will be interesting to knojv the expense of a military hospital in
Manila. Military Hospital No. 1, now a 400-bed hospital, costs the War
Department about as follows for one year:
U. S. currency.
Salaries of seven medical officers who are also officers.. $15,000
Pay of one hundred enlisted men of the Hospital
Pay of twenty-six women nurses 16,000
Pay of forty-five civilian employees 10,000
Cost of rations for above 10,000
Cost of medicines and surgical dressings 6,000
If 400 beds are filled at 35 cents per day for sub-
sistoT! . 51,500
Average cost per patient per day 82J cents.
Later estimates make cost $1.50 U. S. currency.
A civil hospital of the same capacity with native labor and other at-
tendants, officered by American medical men and with about seven first
class trained women nurses and a matron would cost approximately as
follows, for one year:
U. S. currency.
Four medical and administrative officers $10,000
One hundred nurses, attendants, etc 15,000
Seven trained women nurses and one matron 4,000
Forty laborers, teamsters, etc 3,000
Subsistence of above 6,000
Medicines, etc 5,000
Four hundred beds at 20 cents per day 29,000
Total : 72,000
Average cost per day per patient, about 50 cents gold for native patients.
COST OP BUILDING AND FURNISHINGS.
Construction costs naturally vary greatly in different countries and are
governed by prices of material, labor, and style of building for diiferent
climates. Aside from the cost of the grounds, their ornamentation and
the roads leading to and around them, simplicity or richness of the build-
ings, the size and style of construction, cause an important difference in
the cost per bed. In addition to the estimate submitted herewith of cost
of construction in Manila, showing cost per bed to be from $400 to $500
United States currency, the following list is instructive as showing the
cost per bed of various large hospitals :
Lariboisiere, Paris, 612 beds, per bed, $3,250, including cost of grounds,
buildings and furnishings.
The following costs per bed are exclusive of ground and furnishings :
Hotel Dieu, Paris, 566 beds (corridor) $3,000
St. Thomas, London, 588 beds (corridor) 3,250
Without the heavy and extensive foundations neces-
Antwerp Civil Hospital, 380 beds (semi-corridor) 1,800
John Hopkins, Baltimore, 400 beds (pavilion) 4,000
Friedrichshain, Berlin, 620 beds (pavilion) 1,680
Am Urban, Berlin, 600 beds (pavilion) 1,075
Hamburg-Oppendorf, 1,600 beds (pavilion) 875
Dresden Children's Hospital, 114 beds (pavilion) 1,050
Kronprinz Rudolf, Wien, 800 beds, combination corridor
and pavilion 1,600
Offenbach Hospital, 250 beds (pavilion) 850
The more the decentralization of the parts of a hospital are carried out,
the higher the cost. Combination corridor and pavilion hospitals of modern
build require in other countries about $750 per bed and the larger hospitals
on the pavilion plan about $1,000 per bed, and this by avoidance of unneces-
sary luxury in detail.
It is also obvious that the more the sick are divided in separate buildings,
the greater the cost per bed. For instance : the two-story pavilions at Ham-
burg of seventy-two beds, per bed $375. The one-story pavilions at Ham-
burg of thirty-three beds, per bed, $450. The one-story pavilions at
Hamburg of fifteen beds, per bed
In an entirely new institution, the general necessary furniture and fix-
tures without instruments will require an outlay of from $100 to $150 per
bed. The latter sum is scarcely ever exceeded in the most richly equipped
hospitals. The average interior furnishing cost, including the instruments,
is much the same everywhere and can be estimated for Manila from the
following modemly outfitted hospitals :
Hamburg-Eppendorf, per bed *]^gg
Friedrichshain, per bed -tAQ
Am Urban, per bed -j^i^q
Eudolfspital "Wien, per bed 105
Considering the cost of transportation, breakage, etc., $200 per bed should
be allowed for a Manila hospital.
1. That acreage as central and accessible as possible be secured for a
1,500-bed pavilion general hospital. This would require about forty acres.
Also acreage for 100-bed infectious disease hospital of permanent construc-
tion with space about it for 300 patients in tents or barracks in event of a
great epidemic; this would require about fifty acres of ground. This
area would meet all future needs of Manila for many years as far as
hospital sites are concerned.
2. That upon the basis of the population, etc., funds be provided for
constructing a 1,000 or 1,500 bed general pavilion hospital at the rate of
300 beds per year, and that the permanent buildings of the infectious
disease hospital and its laboratory and experimental station be completed as
soon as possible.
3. That, pending your action on a plermanent hospital, arrangements
be made with the San Juan de Dios Hospital for 150 beds to be used for the
present emergency needs of the city; or, if this is found to be impracticable,
that a suitable large building, preferably in the Walled City, be rented and
equipped as the Manila emergency hospital, and that the work of training
native Filipina girls as nurses be started in connection with it at once.
(Sgd.) John R. McDill,
Major and Surgeon, U. S. V.,
Operating Surgeon, 1st Reserve Hospital.
Toward the end of the year 1900 the Philippine Civil Com-
mission began to take an active interest in the agitation for the
hospital, and on January 23, 1901, passed the following resolution
which was transmitted to Major General Mc Arthur, at that time
Military Governor of the Islands :
Resolved that the Commission wishes, if practicable, to establish a gen-
eral municipal hospital in this city, with a capacity of three hundred beds
or more, for the use of the civil servants of the Insular Government and
the white and native population of Manila and the Islands. With a view to
the execution of this purpose the president is directed to communicate with
the Military Governor, and learn from him whether the building now used
as a second reserve hospital can be turned over to the civil authorities of
Manila to be used as a general civil hospital, and whether the equipment of
the second reserve hospital could be transferred to the Insular Government
upon the payment of a reasonable sum therefor to be fixed by a board of
competent officers and physicians; and to inquire further upon what terms
the building now occupied as the second reserve hospital, and the land upon
which it. stands, is held by the Government, and whether the terms of the
lease, if any, would permit a transfer from the United States to the Insular
Immediately after the arrival of the American army in the
Islands military hospitals were established in Manila. The mili-
tary medical corps extended the courtesies of the army hospitals
to civilians when it was possible to do so but, of necessity, this
service was highly unsatisfactory to the citizens of Manila.
In spite of the efforts made to establish a hospital for the ac-
commodation of civilians, this state of affairs continued until the
month of March, 1901, when the situation was somewhat relieved
by the establishment of the Women's Hospital at 350 Gral. Solano.
This institution was intended, primarily, for the accommodation
of women and children only, but in urgent cases men were
A short time after this an agreement was reached between the
hospital authorities and the Government officials, whereby Civil
Government employees were to be given medical and surgical
attendance in this institution, but, unfortunately, it was soon
discovered that the facilities here were inadequate to meet the
demands of the situation ; moreover, the American population was
rapidly increasing, which made it imperative that other accom-
modations be provided.
The first step toward relieving the situation was taken on
August 6, 1901, when the Philippine Commission, by the passage
of Act No. 189, made it incumbent upon the Civil Government
to render medical assistance to its employees and their families.
This provision was followed, on October 1, 1901, by the passage
of Act No. 247, which established the Philippine Civil Hospital.
The need for the hospital was so great that the necessary equip-
ment was quickly procured and the institution opened within the
month, in a part of the buildings on Calle Iris in which it was
located at the time it was abolished on the opening of the General
Hospital in 1910.
In the meantime the Women's Hospital had been merged with
the Cosmopolitan Hospital for which subscriptions had been
raised and a building erected. Elaborate plans were made for
expansion but at the critical period enthusiasm waned, and,
partly due to the fact that patients were now being treated very
cheaply at the Civil Hospital, the project was abandoned in
December 1902. This building is the present City Hall.
The Civil Hospital rate for Government employees was placed
at T2 per day for wards and T5 for private rooms, (one peso,
T, is equal to 50 cents U. S. currency) and accommodations
were furnished at T=3 per day for wards and ¥=6 for private
rooms to those not in the employ of the Government. It cost
the Government an average of about ¥=8.50 per person per day
for all patients for subsistence, quarters, and attendance.
It was realized that the hospital was badly located and poorly
suited to its needs in many ways, but at this time it was prac-
tically impossible to obtain satisfactory buildings. Then again
it was only intended as a temporary location, as the original in-
tention to build a large general hospital had by no means been
That the citizens of Manila had not given up the idea and that
the question was to them a very live one was evinced by a petition
to the Governor and Commission in the early part of 1903.
This petition was signed by people from all walks of life in
Manila. The major part of the petition is reproduced below:
PETITION WITH PREAMBLE TO HIS EXCELLENCY THE GOVERNOR OP THE PHILIP-
PINE ISLANDS AND THE HONORABLE MEMBERS OF THE CIVIL COMMISSION
ASKING FOR THE IMMEDIATE ESTABLISHMENT IN THE CITY OP, MANILA OP
A GENERAL HOSPITAL. 1903
The need of a general hospital in the city of Manila, where citizens
and ratepayers may receive medical and surgical treatment without dis-
crimination or preference is a pressing one. Of the existing hospitals,
San Juan de Dies, though it has 150 free beds, for which the Insular
Government makes some provision, is a private institution; furthermore,
it is poorly situated, and, however great its desire might be, it could not
begin to cope v^ith the needs of the case: the Civil Hospital, though it has
received others than those in the civil employ in the past, was established
for the express purpose of providing for the needs of Civil servants, and it
has neither the accommodation nor the opportunity for a work such as in
the judgment of your petitioners the situation demands; again, the army
hospitals are for soldiers only and are not open to the general public; and
lastly, the voluntary enterprise known hitherto as the Women's and now
as the Cosmopolitan Hospital is a financial failure. As an illustration,
however, of the need of a general hospital, appended to this petition is a
brief statisticial report of said Women's or Cosmopolitan Hospital.
It is obvious, both from our experience in Manila as well as from the
history of such institutions in the United States, that any further attempt
to establish a voluntary hospital would be ill-advised. Unless at the outset
liberal endowments were forthcoming, such an endowment as we could
not hope to secure, the most earnest effort would be destined to speedy
failure. The shifting population of the Philippine Islands, and the serious,
if not insurmountable difficulty of arousing and sustaining interest among
our fellow-citizens at home in a voluntary hospital in Manila, make the
raising of even a modest sum of money a practical impossibility. This
uncomfortable but undeniable fact necessitates the reluctant abandonment
on the part of those who have been active, in the matter, of their plans for
the reconstruction of the Woman's as the Cosmopolitan Hospital. Some-
thing wholly inadequate might be established and made to drag out a weary
existence on a voluntary basis, but what is needed is not merely a hospital
where a public dispensary and a staff of competent physicians, surgeons,
and nurses would minister to outpatients, where the best equipment and
skill would provide for the needs of inpatients, and where sooner or later
a training school for nurses would give Filipinos and others an opportunity
to secure training as is found in home hospitals.
We would base our petition, however, not merely on the fact that a
voluntary effort has been tried and found wanting, but also and chiefly
on our rights as citizens and ratepayers. It is recognized, and justly so,
by the Insular Government that Civil servants should have ample provision
made for them in case of sickness. But is it not so that we, who are sharing
in no inconsiderable degree in the expense of the Government, should have
a place provided for us when, in this country of sudden, serious, and obscure
diseases, we chance to fall ill, especially as the majority of our American
citizens and of English and other ratepayers would be only too thankful
to pay any reasonable rate for treatment if they had a hospital to which
they were eligible? In the cities of the home land citizens demand this as
a right to which they are entitled by virtue of their citizenship. It may
be added here that while a voluntary hospital might struggle in vain for
funds, an institution founded as we propose would be the recipient of gifts
for endowment through bequests and otherwise, if the experience of general
and city hospitals in America affords any sort of guide to what we might
But once more. Behind our selfish needs, which after all are relatively
small as compared with those of whom we would speak, rises the great
army of the suffering and uncared for poor who, at the present moment,
think of a hospital with horror as a dishonor, just as the same class used
to do in the cities of America. It is for these we plead. However valuable
the work of the Board of Health physicians may be, without a general
hospital and a public dispensary, it is greatly handicapped. The work of
mercy that could be done for this vast population of sufferers by a hospital
equipped and manned as well as the science of to-day knows how, would
seem to be as immediate and as imperative a duty as any political service
that could be rendered.
Your petitioners wish to make it clear that in such a project as they
have in mind, they are proposing nothing novel or revolutionary; they are
but following a course that has long since been approved in every enlightened
community. In all considerable cities in America the municipal government
has recognized it to be a duty to establish and subsidize a general or city
hospital with public and private wards. While voluntary gifts are ex-
pected and may aid in the foundation and maintenance of such an institution,
it is broadly conceded that a hospital is a necessity not a luxury, both as
a safeguard for, and as a right of, the community; and that the public
funds, that is to say the money of the people contributed to the municipal
treasury through taxation, should make the main provision for its creation
and support. Furthermore, such institutions for the people are placed by
the authorities in the hands of the people for administration through the
agency of a board of trustees, consisting of representative citizens duly
appointed. All this is a commonplace in American cities and there is no
need of enlarging upon it. Sooner or later a general hospital will be
established in this city as a matter of course, and all this petition aims
at is to hasten the day, on the grounds of the urgency of the need and the
economy of valuable lives in immediate action.
In order that the matter may come before your honorable body in as
concrete shape as possible, your petitioners, in addition to stating the broad
outlines of their desires, have appended by way of suggestion, the Acts
and Ordinances relative to the establishment of the Boston City Hospital.
In view of the foregoing and other considerations, your petitioners re-
spectfully ask the acting Municipal Government of the city of Manila, that
is to say the Insular Government :
1. That a General Hospital be established in the city of Manila at the
earliest moment practicable.
2. That the existing Civil Hospital be merged into the said General
Hospital, with such provision for the separate care of Civil employees as
may be deemed expedient. This is suggested as a matter of economy and
as indicating how it would be possible to achieve the end in view without
an unwarranted increase of expenditure, in event of no preferable plan
being found feasible.
3. That the Women's, or Cosmopolitan, Hospital sink its individuality
in the said General Hospital. The present incomplete building of the afore-
said Cosmopolitan Hospital might be taken over and equipped for the
General Hospital on such terms as were mutually agreed upon by the
Insular Government and the Directors of the Cosmopolitan Hospital, pro-
vided that the said buildings were pronounced, after examination by experts,
to be suitable for the purpose. (See appended Report.)
4. That temporary provision be made for general hospital work until
such time as permanent quarters are completed.
5. That the said General Hospital be free to all without prejudice on
account of race, color, or religion.
6. That, while the main purpose of the hospital be to minister to the
poor, ample provision be made for private patients, who will contribute
special fees determined by the Board of Trustees and used as they may
7. That there be: (a) An out patient department with a public dispen-
sary, (b) A training school for nurses.
8. That, mutatis mutandis, the Acts and Ordinances of the Boston City
Hospital be the basis of the foundation to be known as the General Hospital
in the city of Manila * * *.
The following extract from the Secretary of the Interior's
address upon the -occasion of the laying of the cornerstone of the
hospital, February 28, 1908, gives a portion of the subsequent
history very accurately. The first paragraph refers to the peti-
tion given above :
The Commission was impressed with the reasonableness of most of these
requests and with soundness of the arguments brought forward in their
support. On June 1, 1903, it appointed a temporary committee, consisting
of Governor Taft and Commissioners Worcester, Wright, and Smith, to
confer with the Right Reverend Charles H. Brent, the chairman of the
citizens' committee, upon the question of a general hospital at Manila.
This conference having been held, the committee of the Commission recom-
mended to that body the appointment of another committee, consisting of
the Secretary of the Interior, the Secretary of Public Instruction, the Gen-
eral Superintendent of Education, and the Superintendent of Government
Laboratories, to have general charge of negotiations relative to the proposed
hospital and to meet in joint session with the citizens' committee as occasion
might require. It was instructed to investigate and report as to whether
it would be wiser to utilize the Exposition Grounds, where the building of
the Bureau of Government Laboratories had already been erected, as a site
for a hospital and a medical school, reserving the land which Commissioner
Legarda had offered to donate as a site for secondary schools, a normal
school, and all departments of the future university except the medical
school and possibly the law school; or to accept Commissioner Legarda's
proposition to use the property offered by him for the hospital and to con-
tinue the use of the Exposition Grounds for educational purposes. The
committee was further directed to report on the practicability of erecting
a temporary hospital and also on the possibility of securing from the Army
the Third Reserve Hospital until new buildings could be constructed.
A word of explanation as to the question thus raised relative to the
hospital site. The Bureau of Government Laboratories had long since
outgrown its temporary quarters back of the Civil Hospital. As its work
had increased the necessity for the construction of a modern laboratory
building had become manifest, and when a site for this building was
sought Commissioner Legarda had generously offered to donate a large
lot, beautifully situated on an extension of the Santa Mesa ridge, but
for more than a year unexpected legal complications had prevented his
conveying this land to the Government. Meanwhile the necessity for the
erection of the new laboratory building had become so urgent that the
Secretary of the Interior, after considering all other available locations, had
requested the Commission to set aside a site for it on the Exposition
Grounds, at the same time calling attention to the fact that the erection of
a laboratory building there would logically involve the construction of hos-
pital and medical school buildings on the same tract of land.
The Exposition Grounds had originally been provisionally set aside for
educational purposes, but, with the approval of Professor Bernard Moses,
the Secretary of Public Instruction, the policy of placing the new laboratory
building there was agreed to, as were the logical consequences of this policy.
Meanwhile some of the buildings already on the ground had been occupied
by teachers, and at a later time the establishment of the Normal School
in others had been approved by the Secretary of the Interior, with the
distinct understanding that such occupation of these buildings was to be
temporary and to continue only until they were required for hospital
Several meetings of the joint committee were held, and in the end it was
agreed to recommend to the Commission the utilization of the Exposition
Grounds as a site for the General Hospital and the immediate establishment
of a temporary hospital in the buildings then occupied by the Norinal
School and by teachers, it having been first ascertained that the Third
Reserve Hospital building could not be secured from the military authorities.
The Commission adopted the recommendation of the joint committee relative
to site; but as there were no suitable quarters to which the Normal School
could be immediately transferred, and as its work was too important to be
even temporarily interrupted, decided not to attempt the establishment of
a temporary hospital on the Exposition Grounds, but pending the erection
of new buildings, to utilize to the fullest possible extent, and to increase if
necessary and practicable; the facilities of the Civil Hospital.
The Chief of the Bureau of Construction and Public Works was instructed
to proceed immediately with the preparation of plans for a pavilion hospital
of 300 beds. The joint committee continued its labors, appointing technical
subcommittees on law and on hospital plans. Ultimately it recommended
to the Commission for adoption the draft of an act for the establishment of
the Philippine General Hospital. The preliminary hospital plans prepared
by Architect Bourne were returned to him after being made the subject of
painstaking criticism, and on March 25, 1904, final plans, acceptable in
form to the joint committee, were adopted. Shortly afterward they were
forwarded to the Commission, with the recommendation that constructiofi
work be inaugurated at an early date.
And now this long-cherished and long-delayed project met with a serious
reverse which, for the time being, threatened to be fatal. The Insular Gov-
ernment had fallen upon evil days. In its eagerness for progress it had
expended very large sums for the establishment of a system of public instruc-
tion, the construction of public works, the maintenance of public order, the
preservation of public health, and for other important public purposes. Its
revenues had fallen far short of expectations and were steadily decreasing.
The bare bottom of the Insular Treasury was looming ominously before the
eyes of the legislative body, and unfortunately the carefully prepared plans
submitted by Architect Bourne, and approved by the joint committee, called
for the expenditure of a sum greatly in excess of that which could safely
be made available.
An additional complication now arose as the result of suggestions from
the Commanding General relative to the transfer to the Civil Government
of a number of buildings occupied by the Army, including its Ji'irst Reserve
Hospital. The Secretary of the Interior and the Director of Health were
reluctantly forced to admit that, although the First Reserve Hospital site
was by no means an ideal one and its buildings left much to be desired,
still in view of the condition of the Insular Treasury, if they could be
obtained it was the part of wisdom to accept and to utilize them. Nego-
tiations for securing them were inaugurated and pushed forward as rapidly
as possible, but they dragged on for a long period and finally, during the
visit to the Philipines of the Secretary of War and the Congressional
delegation, the conclusion was reached that they could not be transferred.
Meanwhile the joint hospital committee after some fruitless attempts to
secure aid in the United States, had lapsed into a permanent state of sus-
But help had come from an unexpected quarter. On April 1, 1905, a
committee had been appointed by the Governor-General for the purpose of
inquiring into and thoroughly analyzing the organization of Bureaus and
Offices of the Insular Government with a view to determining the useful-
ness of each Bureau or Offiice, the possibilities of improvement therein by
eliminating the duplication of labor, and the further purpose of considering
the equalization of salaries, the methods employed in bookkeeping, and
generally to suggest any changes in office management that would tend to
simplify methods of labor and be productive of economy and increased
efficiency. This committee was quick to see that in operating a hospital
in a scattered group of unsuitable rented buildings, located on an insanitary
site, the Insular Government was pursuing a poor business policy and that
the money usually paid out in rental represented the interest on a large
sum which might well be invested in suitable buildings, thus making pos-
sible a more economical and efficient administration. The committee in its
report strongly recommended that such buildings be constructed. Mean-
while the condition of the Insular finances had steadily and quite rapidly
improved, and an authorization by the Congress of the United States for
the issue of bonds to the extent of $5,000,000 to secure funds for the con-
struction of public improvements had further relieved the situation. The
Secretary of the Interior filed a vigorous claim against the first bond issue
for a sum sufficient to erect suitable general hospital buildings and, aided
by the Director of Health, undertook to secure the preparation of new plans,
the carrying out of which would result in furnishing the needed facilities
without imposing on the Insular Treasury so heavy a burden as would have
been involved in erecting the building planned by Architect Bourne. This
course was resorted to reluctantly, for the reason that it entailed further
delay, but no other seemed possible.
On April 15, 1905, Dr, Victor G. Heiser assumed the duties of
Commissioner of Public Health which office had been left vacant
by the resignation of Major E. C. Carter. Dr. Heiser, first as
Commissioner of Health and after November 1, 1905, as Director
of Health, gave material and active assistance in helping perfect
plans and later, when the project became a reality, in noting
and correctmg defects in the work. After the report of the
reorganization committee had been received he, on October 4,
1906, sent an urgent communication to the Secretary of the
Interior in which he makes a very concise statement of the neces-
sity for the hospital in the following language :
Within a short time the Civil Hospital problem will necessarily come be-
fore the Commission for solution, therefore, I take this occasion to call
your attention to certain facts and. recommendations pertinent thereto, for
the purpose of setting forth the requirements of the situation.
The reorganization committee, after an exhaustive examination into the
conditions under which the institution is now conducted, reported that:
"The present Philippine Civil Hospital buildings and site are so expensive
and unsatisfactory, that your committee respectfully urges the immediate
construction of the nucleus of a general hospital as a measure of economy
as well as an essential to eiflciency. The present rental charge is ?12,000
per annum, which, at the rate of the last bond issue, would be the interest
on approximately $400,000.00. The number of employees now required, by
reason of the poor arrangement of wards, would be able to care for a
larger number of patients in a properly arranged establishment. The
land immediately adjoining the grounds of the present hospital is so low
and in such an insanitary condition, that, according to a recent survey,
about ?50,000 would be required to make the location even tolerable. It is
reported that inmates of the hospital have contracted diseases traceable
to the conditions just described."
The report, while brief, is so comprehensive and accurate that little
remains to be said except to set forth a few reasons why a modern hospital
is so urgently needed, and this I shall do in numerical sequence for the
sake of brevity, without regard to orderly arrangement as determined by
their relative importance:
1. The contract which the Government enters into with its employees
provides that they shall be entitled to medical care and treatment. It is
impossible properly to meet this obligation under the present conditions.
2. In order that the medical officers charged with the responsibility of
caring for the health of the officers and employees of the Civil Government
may do themselves justice and render that degree of service rightfully
expected by the patients themselves, better facilities are required.
3. In view of the fact that the Commission has to some extent committed
itself to the policy recommended by not making appropriations for the
repairs that will have to be made on the present buildings, if they continue
to be occupied for hospital purposes, prompt action will be necessary.
4. One of the most difficult features, especially in the Philippines, in
the successful administration of a hospital, is the question of keeping an
adequate force of competent nurses. It is proposed to remedy this con-
dition by training native women as nurses, and through them, not only
overcome the difficulty as presented throughout all parts of the Philippines,
but also to eliminate the cirujano ministrante with his uncertain status,
and the mediquillo with his total ignorance of the science of medicine.
5. The death rate of the city of Manila is still abnormally high, and
improvements are hardly to be looked for until there are proper facilities
for studying in hospitals the diseases which are responsible for the high
rate of mortality. During the month of July there were 743 more deaths
in Manila than during the corresponding period of last year. A large
jpercentage of these deaths were ascribed to such indefinite causes as
bronchitis, meningitis, and similar diagnoses, which fact shows the imper-
ative need of better facilities for the application of scientific knowledge
and exact methods of diagnosis in the treatment of disease.
6. The time has come when modern facilities are needed by the hospitals
of the city for the teaching of clinical medicine to physicians and medical
students in order that a new era of practice based on accurate diagnosis
.may supplant the present system of haphazard drug prescribing.
7. Through such a hospital as is contemplated, ample facilities without
additional cost would be available for imparting instruction to midwives
-and medical students in the science and art of obstetrics, and through this
knowledge, to redeem from the present fatal ignorance and superstition,
and save many a life which under the present practice would be sacrificed
-and accounted for as a consequence of the prevailing excessive infant
8. A modern hospital would be a powerful factor in disseminating
sanitary and hygienic knowledge among people. To similar agencies Japan
is indebted for her wonderful health service.
9. The location and structural defects of the buildings now occupied as
-a Civil Hospital, preclude the practicability of remodeling them for a new
hospital, even if the land were the property of the Government, hence the
-advisability of selecting a location which will meet all the requirements,
for instance, such as the grounds near the Bureau of Science, an institution
■on which much of the scientific work of the hospital will largely depend.
Inasmuch as this site is satisfactory with reference to its location and
environments, it is recommended that it be immediately approved and set
apart for hospital purposes.
10. The present Civil Hospital does not offer that privacy for maternity
-cases to which they are justly entitled.
The plans and estimates of the Consulting Architect to the Commission,
are forwarded herewith. While the undersigned is not prepared to indorse
every detail in the plans, yet, on the whole, it is believed they are satis-
rfactory and that such changes as are recommended will not increase the
■estimate beyond half a million pesos.
With a new modern building and increased facilities for taking care of
native patients, the work of the hospital could be made a mighty factor
in demonstrating the sincerity and helpful purposes of the American Gov-
ernment. Foreign mission boards of all denominations rely on their
hospital and medical services to gain the confidence of the people whom
they desire to influence. One satisfied, grateful patient is worth more
than a thousand nominal adherents, as he remains a friend for all time
Commissioner Worcester forcibly expressed his views on the
subject, in a letter to the Governor-General on October 21, 1906,
in the following language which is a partial reproduction of the
Finally, I desire urgently to recommend to the Commission the early
-construction upon the Exposition Grounds of a sufficient number of build-
ings of a pavilion hospital to furnish approximately 200 beds, this hospital
to be constructed in accordance with the plans prepared by the Consulting
Architect which allow of systematic future development through the ad-
dition of other ward buildings which have been planned for at this time
and for which adequate ground space should be reserved in accordance
with the plan now presented.
The question of the establishment by the Insular Government of a
general hospital at Manila is a rather sore subject with me. The utter
inadequacy of the buildings at present used, the insanitary nature of the
site on which they stand, and the very excessive cost to the Insular Gov-
ernment of maintaining this hospital as it is at present conducted, are hard
facts which have been repeatedly brought to the attention of the Commission
and have also been frequently made the subject of by no means unjustified
attacks in the public press. The recommendations of the Reorganization
Committee on this subject are brief and to the point and their soundness
can not, I think, be gainsaid. I long since brought to the attention of the
Commission the urgent necessity for beginning the work of the construc-
tion of a general hospital on a site which would allow of adequate future
development, and served formal notice that as soon as I could secure
accurate statements as to what was necessary at the outset and what it
would cost, I would request an appropriation from the bond issue of an
adequate sum to begin this work, and protested against the inauguration
of any policy which would, so to speak, mortgage the bond issue to such
an extent as to render impossible hospital construction to be paid for from
funds obtained in this manner.
I understand that it was formally agreed that a reasonable expenditure
from the bond issue for this purpose should be made. Fortunately, how-
ever, the improvement in the financial condition of the Insular Government
makes possible the expenditure during the present year of a considerable
sum from general revenues for public improvements. It is immaterial to
me whether the necessary amount is appropriated from the bond issue or
from other Insular funds, but I strongly urge upon the Commission that
at this time it put an end to the present unsatisfactory conditions and
make adequate provision for an institution which shall be a credit to the
Insular Government. * * *
In closing, I beg to suggest that the only considerable expenditure ever
made by any of the Bureaus of the Department of the Interior for puWic
improvement has been the comparatively small one involved in the con-
struction of the new building of the Bureau of Science, while very large
sums have been expended for public improvements by other Departments
of the Insular Government. I feel that it is no more than just that this
great need of the Department, which is at the same time a public need,
should now be met.
I have myself been repeatedly publicly charged with delaying the work
of hospital construction. The members of the Commission, at least, are
well aware that I have favored only such delay as would allow the secur-
ing of a proper site and of adequate plans. Inasmuch as the amount
expended must necessarily be large, I have determined that the necessary
steps should be taken to secure wise expenditure before I would make
recommendation to the Commission. The hospital plans originally prepared
by the former Chief of. the Bureau of Architecture and Construction of
Public Buildings involved what was, in my opinion, an extravagant expendi-
ture and I was therefore not prepared to recommend their adoption. The
plans prepared by the Consulting Architect seem to be the best that we
can secure and I think that they should be adopted.
It is probably needless for me to say anything in regard to the site for
these buildings as this has been fixed long since by the Commission and so
far as I know there is no purpose at this time to reverse the action then
taken. There is, however, every reason why the buildings should be put
on the Exposition Grounds. This site is cool and can readily be made
sanitary. It is well removed from noise and dust and there is sufficient
ground 'to allow for all probable future development. Proximity of the
building of the Bureau of Science will be a very great convenience and
will save some little expense.
I am more than ever convinced that this piece of ground should be
reserved for the scientific work of the Insular Government.
Quoting further from the address of the Secretary of the In-
terior upon the occasion of the laying of the cornerstone we find
the later history of the formative period of the hospital related as
As rapidly as possible Mr. W. E. Parsons, the Consulting Architect to
the Commission, prepared preliminary plans and estimates, and prior to
the departure of the Secretary of the Interior for the United States in
October 1906, they were transmitted to the Commission with an urgent
request from that official and from the Director of Health that the necessary
funds for carrying them out be immediately appropriated and the construc-
tion work inaugurated as soon as possible.
Other counsels prevailed, however, and the whole project was laid on
the table where it was found peacefully reposing by the Secretary of the
Interior on his return in April, 1907.
Before making final recommendation to the Commission, he deemed it
fitting and desirable to secure the opinion of the faculty of the newly
established Philippine Medical School as to the necessity for a Government
general hospital. The faculty immediately approved the project but ob-
jected to the small number of beds planned for at the ouset, insisting that
300 should be provided for instead of 200 proposed. The arguments which
they brought forward in favor of this course seemed unanswerable, and
the Director of Health and the Secretary of the Interior united in request-
ing the Commission to appropriate the sum of ?'780,000 in order to make
possible the erection of a central administration building, a surgical
pavilion with two operating rooms, a building for dispensary and outclinic,
five ward pavilions of sixty beds each, a nurses' home, a kitchen, an
ambulance stable, and morgue. By unanimous vote of the Philippine Com-
mission the full sum requested was appropriated.
It was with a profound sense of gratification that those who
had labored so long and earnestly for the completion of the project
finally saw a chance for the realization of their hopes. With
the necessary funds available the greatest obstacle had been swept
away, although the real, active, hard work remained to be done
as there were a multitude of details to be thought out and unfore-
seen complications arose continually.
A meeting of the Philippine Islands Medical Society was to be
held in Manila early in 1908 and this was deemed an opportune
occasion of the laying of the cornerstone of the new hospital.
Accordingly, although no contracts had been let nor had the
exact locations of the different structures been determined, the
cornerstone was laid February 28, 1908.
Dr. Fernando Calderon, a leading Filipino physician of Manila,
during an address upon this occasion made the following state-
ments, several of which strike to the core of the subject :
The construction of the edifice whose cornerstone is laid today in this
beautiful field endowed with unsurpassable hygienic conditions is an event
which ought to be greeted with rejoicing by all the Filipino people.
It signifies in the political order that the Insular -Government, abandon-
ing the individualistic theory of laissez faire, is convinced that its sphere
of action is not limited merely to administering justice and maintaining
the liberty of the inhabitants of this archipelago, but that it must, in ad-
dition, watch over those neglected by fortune, the weak ones of society,
supplying their most pressing necessities.
Among those necessities it is indubitable that the preservation of the
life and the health of the citizens occupies first place; wherefore, the
Government, inspired by the modem ideas of democratic and cooperative
governments, and complying with a duty not merely moral and altruistic
but juridicio-social, decided to build a public hospital sustained from
public revenue for the benefit of the 7,000,000 inhabitants who people these
Islands in general, and those neglected by fortune in particular.
The hospital will be named the Philippine General Hospital, because it
will be destined principally for the use of the Filipino people. It will
inaugurate its work with 350 beds, and will consist of several pavilions
constructed in modern styles to avoid massing the patients.
It VTill have the following departments:
2. Surgical operating rooms.
5. Nurses' home.
6. Pavilion No. 1 (private rooms).
7. Pavilion No. 2 (surgical cases).
8. Pavilion No. 3 (medicine).
9. Pavilion No. 4 (children, medicine or orthopedics).
10. Pavilion No. 5 (obstetrics).
The first five departments, that is, those destined for administration,
operating rooms, kitchen, dispensary, and the nurses' home, will be built
of such size that they can serve permanently as the fundamental basis of
the future hospital, even though it should become necessary in the future
to construct a larger number of pavilions.
The pavilion of medicine will open its doors to the sick who belong to
the group of medical pathology, and especially to those who are suffering
from tropical diseases, from local causes of climatology, physiology, habits,
customs, and alimentation. Difficult medico-social problems for the physical
regeneration of the Filipino race will be solved in this pavilion of medicine.
The pavilion of surgery will be open to persons suffering from surgical
affections, and in case operations are performed upon them, they will not
be mixed with the patients in general medicine, there being thus constituted
a certain guarantee against all infectious contamination.
And what shall I say of a pavilion destined for the sick children of
Manila where these tender beings die annually by thousands, the total of
infant mortality ascending to a number capable of horrifying the most
temperate mind? I shall say only two words: That it is a long-felt social
necessity in order to be able to undertake clinical infantile diseases of
Philippine type, as yet unknown to science.
Neither shall I dwell on the highly important services which, in its day,
the future pavilion of obstetricts or clinic of parturition which is to be
•erected, will render to the women and children of our country, because all
will comprehend the necessity for an ample, hygienic and comfortable place
to which those unfortunate women can go to give birth, who now perform
that transcendental act of life in miserable, insanitary huts, completely
^ven over to charlatanism and the ignorance of the illegal practitioners
"who officiate as midwives, with great danger to them and their new-born
A general hospital with 300 beds for a city like Manila with 220,000
inhabitants, in addition to the sick coming from the provinces is not, we
may say, a very spacious hospital for completely filling the requirements
of so numerous a population.
The systematic opponents of the projects, those traditional reactionaries
of the first class who find nothing good except conversation and routine,
will say, perhaps, that since some hospitals already exist in Manila why
burden with this new weight the budget of the country which is now under-
going an economic crisis; but let such professional critics remember that
what constitutes the nerve of human civilization in the present epoch is
precisely public hygiene in the towns in general and the health of each
citizen in particular, for which purposes modern governments do not spare
tixpense to place them on the highest plane.
True, there are in Manila some hospitals of antiquated styles, in truth,
such as San Juan de Dios, St. Paul's, the Civil Hospital, the University Hos-
pital, and Bethany, which are far from answering the present needs of this
•city. I do not mention the sick-ward of Bilibid nor Hospital "B" of Bilibid
Prison, nor the military hospitals located here, because they are for the ex-
clusive use of prisoners and the Army. The San Lazaro pavilions do not
•constitute a hospital but only isolation houses for cases of cholera, bubonic
plague, and smallpox.
The hospital of San Juan de Dios, to which the Filipino people owe
immense gratitude, as it has really been the only beneficent establishment,
vyhich, from its own funds, and within its limited means has been admitting
poor sick, at present maintains about 100 beds for the needy, apart from the
60 paid for by the city government.
St. Paul's Hospital has funds at its disposal to support only fourteen
beds destined for poor children, as the other 100 beds for indigents which
are. there at present are paid for, 50 by the city and 50 by the Philippine
The Civil Hospital does not support any, except a few for emergency
cases, the University Hospital fifteen beds and Bethany Hospital, improp-
erly so called because it is nothing more than a dispensary, supports six
beds for children and poor women.
Not counting, then, those 150 official beds which the Government will
take over by erecting its own hospital and putting its poor sick under better
^hospital conditions, how many beds for the poor sick would there then be
available for the entire city of Manila? The insignificant number of 135
Thus this new edifice, capable of receiving 350 sick, a very small part
of whom will be paying patients, comes to fill an immense void in the capital
of the Archipelago.
It is plain that even with such a number of beds we shall still not have
reached the desideratum of the aspirations directed towards sending to a
hospital and caring for all the poor sick of the city of Manila and the
surrounding provinces who may request aid. A hospital with capacity for
a thousand patients would be necessary for this.
If, in this same manner that the American Congress every year votes the
money necessary for the construction of four battleships, the Insular Gov-
ernment, imitating this example and adopting a definite program, were to
grant, if only two years, money sufficient for the erection of a new pavilion
destined for this general hospital, at the end of a few years we should see
the realization of the beautiful ideal of being able to send to a hospital the
poor sick who swarm Manila and the adjacent provinces.
The cornerstone was laid by the Secretary of the Interior, the
Honorable Dean C. Worcester. A portion of his address delivered
at this time is quoted below :
Our distinguished guest. Sir Allen Perry, in his eloquent and most in-
teresting address, has brought forcibly to your attention the vital im-
portance of adequate hospital facilities in the tropics, even suggesting as
a criterion of civilization of a country, the number of its hospitals and the
character of their equipment. His position entitles him to speak with
authority on this subject, for perhaps in no other tropical country has
hospital work reached so advanced a stage of development as in Ceylon.
Professor Calderon has clearly demonstrated the great need of govern-
ment general hospital at Manila and has made plain the substantial benefits
which will accrue from it to the people of that city and of the Philippine
If the statements of these gentlemen are true, and we know that they
are true, the question naturally suggests itself, why has the Insular Gov-
ernment . so long delayed the establishment of an institution which is
destined to be so useful and which has been so imperatively needed?
It has fallen to my lot to give a brief review of the facts. Had I been
requested to justify, in all particulars, the policy which has been pursued,
I should have declined the honor. Speaking candidly, I am of the opinion
that the establishment of a general hospital has been unduly delayed.
Nevertheless, it is true that grave obstacles have been encountered, and
the facts when stated will extenuate, even if they do not fully excuse, the
course which has been pursued.
The present hospital situation in these Islands, so far at least as con-
cerns Government institutions, is most abnormal. The Insular Government
made provision for sufferers from bubonic plague, smallpox, cholera,
leprosy, and other dangerous communicable diseases by the establishment
of the San Lazaro Hospitals and the Culion lieper Colony. It has erected
a fine hospital for the proper care of the insane. It has established
admirably equipped quarantine stations at Manila, Cebu, and Iloilo. Yet,
while very heavy expense has thus been incurred in caring for the insane,
in providing hospital facilities for the comparatively limited number of
sufferers from dangerous communicable diseases, and in preventing the
introduction and checking the spread of such diseases, little has been done
to relieve the afflictions of that larger portion of the population suffering
from ills which are not readily communicable to others and may be mini-
mized, or completely relieved, by medical or surgical intervention.
We have, to be sure, free dispensaries in the city of Manila. We have
also our Civil Hospital; but the latter institution is established in a group
of three buildings which were intended for private residences and are not
really suitable for hospital purposes. The largest of them has in its im-
mediate vicinity marshy, mosquito breeding lands which can neither be
drained nor filled at reasonable expense, and which necessarily render the
site highly objectionable. Furthermore, the space available in this insti-
tution is to so large an extent required for Government officers and em-
ployees that at best comparatively few beds are available for the general
In order to make some provision for the needy poor of Manila and to
secure necessary clinical facilities for the students of the Philippine
Medical School, we have been forced to hire beds in private hospitals, and
it is indeed fortunate that we have been able to do so.
At last this extraordinary condition of aifairs is to be terminated. How
is it that it has been allowed to continue so long?
Professor Calderon has just advanced the claim that the Philippine
Medical School should be considered the mother of the Philippine General
Hospital because of the adoption of the recommendation of its faculty that
the number of bqds to be established at the outset be increased to 300. He
has assigned the relationship of grandmother to the Bureau of Science and
that of great grandfather to myself.
May I be permitted to suggest that he has left a serious gap in the
parentage of this lusty infant and to nominate for the important position of
father the Director of Health, Dr. Victor G. Heiser. I regard the desire
of the Medical School to establish relationship as a distinct compliment to
the child. I have noticed that in the case of the public improvements in
the Province of Benguet there was at one time a distinct willingness to
accord to one man the honor of being the whole family of that infant, but
later when the great highway to our summer capital had been completed
and people had begun to realize what we had obtained for our money, there
was no longer a lack of would be near relatives. Even an orphan can usually
find foster parents if he becomes sufficiently promising as he develops.
Far be it from me to try to keep the Philippine Medical School out of the
General Hospital family, but a due regard for the verities of history
compels me to call attention to the fact that a comparison of the date of
conception of the General Hospital project with that of the date of the
birth of the Philippine Medical School forever debars the latter institution
from any claim of motherhood. To the Philippine Commission, which ap-
propriated the necessary funds, should, I think, be assigned maternal honors
in this case, but the valuable assistance rendered by the Philippine Medical
School in moulding public opinion and in demanding a suitable increase in
the number of beds certainly entitles it to rank as nurse.
We have met to-day to lay the cornerstone of the Philippine General
Hospital. Although the delay in providing for this institution has been
long and at times disheartening, we may well feel that it has in large
measure been compensated for by the liberality of the provision which has
now been made. The hospital has been planned on broad lines. With the
very adequate facilities which it will have at the outset for administrative
officers and for operative surgical work, its capacity can be almost inde-
finitely increased by the construction of additional ward pavilions. The
Exposition Grounds are amply large to admit such expansion and must be
kept available for hospital purposes.
When the Philippine General Hospital, the Philippine Medical School
and the Bureau of Science buildings stand, as they soon will stand, side by
side, with the Bureau of Science working, as they have always worked and
must always continue to work, hand in hand, this Government may, I think,
feel that it is not only fulfilling its duty in safeguarding the health of the
inhabitants of these Islands, but that it is contributing its full share toward
the solution of the many grave problems involved in combating tropical
■diseases, and in making tropical countries not only habitable but healthful
for men of every race. Who shall measure the future usefulness of the
institution which we are about to found in alleviating human misery, in
prolonging useful lives, and in training the men and women of this country
^s nurses, as physicians, and as surgeons? I count it both a great privilege ;
and a high honor to lay its cornerstone. ''i
The herculean task of perfecting plans and specifications for
the different structures, in order to have them adapted to their
purpose and at the same time be covered by the appropriation
and the deciding of many other details consumed considerable
time so that bids were not advertised for until June 24, 1908.
When the bids were opened on July 27, it was found that the
lowest bid had been made by H. Thurber, of the Manila Con-
struction Company. He was accordingly awarded the contract,
for the erection of the administration, medical, surgical, mater-
nity, private, orthopedic, and operating pavilions and. the kit-
chen, on September 8, 1908 for the sum of tP530,804. His
contract specified that these structures be of reinforced concrete
and that they be completed within 240 working days. The
plumbing, wiring, filling, and a few other minor details were not
included in this bid.
Such in brief, is the early history of the institution and we now
<2ome to the more interesting stage of results obtained by nine
years of striving.
Actual construction work was begun shortly after the awarding
of the contract but the usual number of vexatious delays occurred,
conferences were held and changes in plans made until it became
evident that the buildings would not be completed within the
specified time. The contractor asked for and received two exten-
sions on the time contracted for, the sum of which extended the
date for the completion of the structural work to November 30,
After the structures were erected the process of finishing the
interior and obtaining and installing equipment necessitated sev-
eral months so that the opening of the institution was deferred
to a much later date than was originally intended.
The question of supervision of the hospital had been definiteljr
settled by the passage of Act 1989, which took effect July 1, 1910.
The portion of the Act covering this question reads as follows :
The Philippine General Hospital is hereby declared to be a division of
the Bureau of Health, * * * and the Director of Health shall cause
to be furnished in the Philippine General Hospital care of Government
patients as now required of him by Act Numbered Fourteen hundred and
seven. Rules governing the admission of patients to the Philippine General
Hospital, charges for hospital service and hospital administration shall be
made by the Director of Health, subject to the approval of the Secretary
of the Interior. Provided: That the selection of patients for admission to
free beds set aside for the use of the Philippine Medical School shall be
subject to such rules as the Board of Control of the Philippine Medical
School may prescribe: and provided further: That the Director of Health,
subject to the approval of the proper head of department or of the Board
of Control of the Philippine Medical School, as the case may be, may require
the services, without additional compensation, of any medical officer or
employee in the Government Service. (Act No. 1989.)
The "General Statement" of the Secretary of the Interior writ-
ten for the hospital rules and regulations contains some very per-
tinent facts as evidenced by the following extracts therefrom :
The Philippine General Hospital opened its doors to the public on Sep-
tember 1, 1910. This event marked the successful termination of efforts
which had extended over many years. At the outset it was necessary to
create in Manila a proper interest in the establishment of a large modern
Government hospital. When this had been done, plans and estimates were
necessary as a basis for a request for an appropriation. It was by no
means easy to secure plans for a series of hospital buildings which would
admit a maximum of light and air and at the same time should not become
excessively hot during the middle of the day; nor was it easy always to
harmonize the technical requirements deemed essential by the Director
of Health and the Secretary of the Interior with the artistic features ad-
vocated by the Consulting Architect. A long time necessarily passed before
final plans were agreed upon, but it is believed that it was time well spent.
Immediately adjacent to its grounds are the buildings of the Bureau of
Science with excellent laboratory facilities, and the building of the Phil-
ippine Medical School. This gives an ideal arrangement. Laboratory
work for the hospital is performed by the staff of the Bureau of Science.
Access to the hospital and to the library and laboratories of the Bureau of
Science is easy for medical students, and the hospital profits by the services
of physicians and surgeons who are employees of the Bureau of Science and
of the Philippine Medical School.
Under this arrangement, which makes possible the utilization of the best
men in the service in connection with hospital work for which they have
demonstrated special aptitude, it has been possible to organize a staff of
very exceptional ability. It should not be supposed, however, that patients
of the hospital have any limitation imposed on their choice of physician or
surgeon. The institution is open to every reputable practitioner and every
patient has the right to call the physician or surgeon of his choice.
The Philippine General Hospital will fulfill four distinct needs.
It will offer to the general public exceptionally good facilities for the
healing of injuries and the curing of diseases.
It will assure to officers and employees of the Government, who are
entitled to have medical or surgical care free of charge, a quality of attend-
ance seldom equaled and it is believed never excelled under similar conditions.
It will offer to medical students exceptional facilities for practical in-
struction. For the outset there will be one hundred free beds which will
be used for purposes of instruction in connection with the Philippine Me-
dical School, and the teaching clinic of the institution will be open to any
properly accredited student of medicine and surgery.
Thus the hospital will from the outset not only meet the needs of Gov-
ernment officers and employees and those of many private citizens who
are able and willing to pay for the accommodations and services which it
affords, but will be a great public charity as well.
Finally, it will accomplish another very important work in the training
of young Filipino men and women as nurses. Many of these nurses will
go out into the provinces as veritable missionaries of modern medicine,
surgery, and hygiene with the natural result that thousands of lives will
be saved among those who to-day have little or no understanding of the
importance of availing themselves, when injured or ill, of the facilities
which modern hospitals afford. One of the most important things to be
done is to arrange a systematic search in the provinces for surgical cases
which are operably relievable, bring such cases to the hospital where they
can be dealt with under most favorable conditions and keep them there
until recovery is well advanced or is complete.
The future development of the work of the Philippine Medical School,
the Philippine General Hospital and other divisions of the Bureau of
Health, and the Biological Laboratory of the Bureau of Science will not
only relieve an immense amount of avoidable human suffering, but will
ultimately bring about the hygienic regeneration of the Philippine Islands
by their own people. Meanwhile we may hope for the carrying out of
scientific investigation leading to results of very great importance to
this and other tropical countries.
As previously stated, the long looked and hoped for day arrived
and the hospital v^as officially opened on September 1, 1910, and
a largely attended public reception was held in the hospital in
honor of the event. On the following day ten patients were
transferred from the old Civil Hospital to the new structure;
coincident with this act the former institution passed into oblivion
after more than nine years of useful, if somewhat turbulent, ex-
The new hospital is situated nearly in the center of a tract
of land bounded by Calle Padre Faura on the north, Taft Avenue
on the east, Calle Herran on the south, and the weather observ-
atory grounds on the west. This tract contains nearly 11 hec-
tares (27 acres) and is known as "Medical Center" on account
of the Bureau of Science and the College of Medicine and Surgery
being located on the same plot. (See block plan) . -It is most
conveniently located, being well within the city limits and acces-
sible by two trolley lines.
A new set of rules and regulations were promulgated and
inasmuch as it is a Government institution and physicians are
permitted to treat private office patients in the hospital these
rules were, of necessity, peculiar to this hospital. Many problems
have had to be solved and new rulings made; however, in spite
of all the obstacles encountered, it has gained steadily in popular-
ity and efficiency due in part to the hard work and persistent
efforts of the acting superintendent.
The moral influence of the hospital and object lessons taught
patients and servants along the line of cleanliness and sanitation
are bound, ultimately, to make their influence apparent in the
home lives of the people and this brings to light another field of
The Superintendent in his annual report sums up the objects
of the hospital as follows :
The objects to be accomplished by the Philippine General Hospital are
varied. The patients also fall into a number of classes:
The following table outlines both objects and classes :
To care for Government employees
when sick Beneficiaries.
To provide hospital service for the
city's poor and injured City contract patients.
To provide hospital accommodations
for the general public Pay patients.
To provide hospital accommodations
for such poor and needy as have
diseases which are useful and in-
teresting for clinical instruction.. Medical College patients.
To provide a hospital where re-
search work and study of disease,
its cause and cure, may be unre-
strictedly pursued Scientific cases.
To provide immediate treatment for
the injured, or actually ill, with-
out any other aim than to be of
help in time of need Charity cases.
There are four fundamental functions that are paramount in this
hospital. They are as follows, arranged according to their rank and
The Patients. — Care and treatment of the sick and injured.
The Disease. — Research and study of disease.
The Doctor. — Education of physicians.
The Nurse. — Education of nurses.
GENERAL AND SPECIAL FEATURES.
Ambulance service. — Patients are transferred to and from the
hospital by means of electric ambulances, by means of which the
transfer is made in the shortest possible time and giving them
the greatest degree of comfort possible during this time. A
physician accompanies the ambulance and gives the patient any-
necessary attention during the trip to the hospital. The new
garage and waiting shed has been completed and has sufficient
capacity for the accommodation of 2 ambulances, 4 automobiles,.
12 calesas and 6 victorias.
Beds. — The type of bed furnished a patient has much to do
with his bodily comfort and equanimity of mind. The beds with
which the hospital is equipped are admirably adapted to give the
best results along these lines. They are three-quarter size iron,
white enameled, have good springs and mattresses and are sup-
plied with five-inch rubber tired wheels, which make it very easy
to move them from place to place noiselessly and without jarring
the patient. A number of the adaptable "peritonitis" beds are
in use and are a very valuable adjunct to the comfort of certain
classes of patients in that they may be adapted to any position
or angle in which it may be desired to place a patient.
Clocks. — Upon entering the vestibule, a large clock is seen to
the left; this is the master of the system of electric self-wind-
ing and regulating clocks with which the hospital is equipped.
They are distributed as follows :
Administration pavilion 5
Surgical pavilion 2
Medical pavilion 2
Maternity pavilion 2
Orthopedic pavilion 2
Private pavilion 2
Operating pavilion 4
Kitchen pavilion 1
Nurses' home 2
Garage " 1
The master of the night watchman's checking system is located
in the main office and substations are found in all parts of the
hospital. The watchman is required to register at each of these
stations at stated intervals.
Electric fans. — The entire hospital is provided with facilities
for the use of electric fans; while in some instances a charge
is made for them, it is very moderate, and many a weary sufferer
is afforded a great deal of comfort by their use.
Furniture. — The furniture is made of native hard wood, which
when polished, closely resembles mahogany. The doors and
other woodwork are also made from this class of wood.
Grounds.— The hospital grounds are gradually being laid out
and parked according to the scheme of an expert in this line of
work, and when completed will be most pleasing to the eye;
palm trees are being planted and plants and shrubs set out in
conformity with the general plan.
Linen and silver. — The table linen bears the coat of arms of
the Philippine Government and the seal of the Bureau of Health,
both of which are woven into the cloth. The towels have the
words "Bureau of Health" woven into them. Sheets and pillow
cases have the words "Bureau of Health" stamped on them. The
hospital silver is neatly engraved with the Bureau of Health
Telephones. — Four trunk lines enter the building from the out-
side and connect with a local exchange in charge of a Filipina
operator; twenty-nine telephones located in private rooms and
various other parts of the hospital give a very satisfactory service
as one may talk over the city lines from any one of these house
The operator also has charge of the system of call bells for
summoning the resident physicians and superintendent ; each per-
son has a certain number of rings assigned him as his call, and
when in use the call rings simultaneously in all parts of the
hospital ; this system solves what would otherwise be a most an-
noying and difficult problem in an institution of this size.
Ventilation. — Even the most critical can find no fault with
the ventilating scheme of the hospital as practically the whole
sides of the pavilion may be thrown open by means of the
sliding doors with which they are supplied ; these doors open on
a veranda, where many patients are made comfortable during the
day. It was originally intended to screen the whole institution
but this idea was later abandoned and nets were placed on the
beds to exclude mosquitoes, fiies, and other insects.
Water closets. — A number of the Capoco plate vitreous china
closets with "Sanitoure Pyralin" seats have been installed in the
hospital. They, apparently, are the last word in this line of
equipment from a sanitary standpoint.
Upon entering the hospital by the main entrance one is at once
favorably impressed by the magnitude and pleasing appearance
of the vestibule which extends to the full height of the building.
On either side are seen attractive iron gratings separating the
record room from the vestibule on one side, and from the main
oflJce on the other. The floor is laid with large, square, black
alternating with white vitrified tiling. A telephone has been
placed here for the accommodation of the public. A touch of
decoration is supplied by the presence of a number of potted
plants. In the main office to the right are located desks for the
use of the superintendent, chief clerk, chief nurse, supervising
nurse, and their stenographers. Two stenographers are em-
ployed here for the sole purpose of writing up records. This is
one of the busiest parts of the hospital as practically all the
business and financial details are attended to here and in an
institution of this size this necessarily involves a vast amount of
A large fireproof vault is built into the wall of this office in
which are kept valuable records, and silver which is not in use.
Upon request, patients' valuables are stored here free of charge.
The office is light, airy and sufficiently large to avoid crowding;
at night it is amply lighted by electricity. Corrugated iron doors
are in use though solid wooden doors are also provided.
Adjoining the office is the supply room where supplies are
distributed to the wards, upon requisition, at stated intervals.
The next two rooms are utilized for receiving ambulance patients.
To the left of the vestibule are found the record and interns'
room. Here are stored case records and other matter of a
similar nature; this room also serves as a physicians' office and
conference room. Adjacent to the record and interns' room
there is a room which has been designed for a library in which
will be installed book shelves and library furniture and which
will contain a number of modern works on medicine and surgery.
The balance of the rooms on this floor are used as private offices
by the resident physicians.
The second floor is given up to bed rooms for the resident
physicians with the exception of a large room which is at present
used as a storeroom.
For the exact location and size of rooms the reader is referred
to the floor plans of the various pavilions.
It is interesting to note that the first meeting of the Far
Eastern Association of Tropical Medicine was held in this pavil-
ion in March 1909.
MEDICAL AND SURGICAL PAVILIONS.
The medical, surgical and orthopedic pavilions are arranged in
practically the same manner; for this reason only the surgical
pavilion floor plans are reproduced. The three buildings have,
on each floor, a large ward capable of holding sixty beds, and
a smaller one intended for fifteen beds.
The private pavilion contains a twenty-bed ward, a two-bed
isolation ward, and sixteen private rooms on each floor. The
first floor was occupied on March 25, 1911.
The second floor of the obstetrical pavilion contains twelve
R I D O R
Scale '/lOO m.
private rooms, a twelve-bed ward, a nursery for newborn babies,
a delivery room, a sterilizing room, and a physicians' waiting
room. The doors of the nursery are solid and tight fitting so
that patients on this floor are annoyed as little as possible by the
crying of the babies. The first floor, or Filipina maternity, con-
tains a thirty-bed- ward, a twenty-bed ward, an isolation room
for infected cases, a delivery room, a babies' bath, and a phy-
sicians' waiting room.
All of these floors are provided with a diet kitchen, two bath
rooms, toilet and slop room, linen room, and lockers for patients'
effects. They are also provided with annunciators, telephones,
and other modem conveniences.
This most important component part of the modern hospital
is centrally located with reference to the other pavilions. The
structure is 15,4 by 22.1 meters in size and is two stories high.
The relative locations of the various units comprising the whole
are shown on the floor plans of the building ; in this connection
let it suffice to state that the various rooms are conveniently
located and that the construction and plumbing are thoroughly
sanitary in every respect.
On the second floor are found two operating amphitheaters
each with a seating capacity, for spectators, of about eighty
and another room for fifty. Clinics are held here for the med-
ical school students; in fact all ward surgery is done in these
rooms. The floors of the whole pavilion are laid with 2-inch
white hexagonal tile and floor comers are rounded to permit of
thorough cleansing. The rooms are well supplied with modem
surgical instruments and appliances and one has only to visit the
pavilion any morning to realize the large amount of work that
is being done there.
A very valuable addition to the operating room equipment is the
Carl Zeiss electrical illuminating device for operating theaters.
Dr. McDill has kindly furnished the following description of
The cloudy days so frequent during half the year in Manila interfere,
to a very great degree, with clinical surgical instruction. One of the two
new operating amphitheaters in the hospital is equipped with the Zeiss
The light is derived from a 30-amper search light, located in the
corridor outside of the operating room, which projects a shaft of intense
light through a hole in the wall after passing through a chamber containing
distilled water; the water is kept cool by circulating between the chamber
and a box at one side; this cools the light.
The main shaft of light strikes a target containing eight distributing
mirrors (see illustration), each of which reflects its light to a correspond^!
ing mirror attached to the ceiling, only five of these show in the illustra^
tion ; a horizontal distributing mirror, the same height as the operating
table, is used to illuminate the field in perineal work.
Each of these eight illuminating mirrors, one of which is for vertical ,
rays, reflects its pencil of light to a circle corresponding to its own size
on the desired point on the operating table; hence, as all of these pencils ^
of light converge at one spot, the illumination effected is a seven-sided,-^
intensive illumination of the operative field and of any wound, no matter
The illumination is free from heavy shadows and is uninterrupted when
operators and assistants stand in the rays from even four of the mirrors.
Spectators in the rear of the ampitheater can easily recognize anato-
mical details that formerly were visible only to the operator.
The advantages gained by the use of this apparatus are as valuable'
to the operator as to the spectator; there being no noise, no heat and no
eye-strain. There is no possibility of dust dropping into a wound from
this apparatus and lastly it is easily kept in working order.
On the first floor a fully equipped private operating room is
found, which is open to any reputable surgeon.
The whole pavilion is well lighted with electricity, plumbed
for hot and cold water, supplied with electric call bells, telephones,
and other conveniences.
Each floor is provided with an up-to-date sterilizing room, con-
taining the recognized apparatus of the modem sterilizing room.
A room on the ground floor is fitted up for eye, ear, nose, and
throat work and contains equipment of sufiicient quantity and
quality to care for any class of disease belonging to this depart-
ment in the best possible manner.
Another very important aid to efficiency, located on the first
floor of the surgical pavilion, is the X-Ray and Electro-Thera-
peutic department. This work was taken up on January 10,
1911, and until July 1, 1911, a total of 120 photographs had
been taken, 90 fluoroscopic examinations made and 128 electrical'
treatments given for carcinoma, epithelioma, lupus, exophthalmi^
goiter, blastomycosis, dhobie itch, acne, leukemia, and similar
The equipment of this department includes a powerful inter-
rupterless Roentgen ray machine ; high frequency apparatus for
giving the various forms of electrical treatment ; a modern elec-
tric diagnosis apparatus including sigmoidoscopes and explora|
tory lamps ; diagnostic and treatment combinations for the elec-
trical treatment of the kidneys, bladder, etc.
Plans have been drawn for a complete mechano-therapy plant
which, when completed, will supply every need along the line|
of electro and hydrotherapy. The plans call for a two-sto.:^
building in which one floor shall be devoted to Russian and
vTEl ROOMS I PRIVATE I ROOMS
Scale Vioo m
Ij^BBm ^i^J ^^9^V H
Turkish baths, bath battery, hydrotherapy, the Schott treatment
and exercises, and a complete Zander outfit with the necessary
The second floor to be occupied by the Roentgen ray, electrical
diagnosis, and treatment departments.
It is hoped to connect with it a modern cooled ward for the
treatment of the various tropical neurasthenias and it is believed
that much can be done to alleviate these annoying and persistent
disorders with this method of treatment. The whole plant is,
of course, to be under the management of trained experts in their
Probably no other department of a hospital has to bear the
brunt of so much fault finding and causes so much dissatisfaction
as that concerned with the selection, cooking, and serving of
patients' food. This, of course, is partly on account of the average
patient's not knowing exactly what he does want or not wanting
anything, but unfortunately the patient is often justified in com-
plaining. Rarely does one find a hospital where so little cause
for dissatisfaction along this line exists as in the Philippine Gen-
eral Hospital. The writer has been in the hospital both as guest
and patient, and is pleased to be able to state that there was
no opportunity for finding fault with the quantity or quality of
the food. Another feature which is a source of much satisfac-
tion to the average person is that the housekeeper visits the
private patients daily to ascertain what particular articles of
food they desire. If not contraindicated their wants are carried
The kitchen is two stories in height with no second floor thus
giving abundant air space. It is 12.7 by 21.33 meters in size,
is located at the rear of the present group of buildings and has a
main kitchen and five side rooms.
The kitchen proper contains a duplex double-faced range with
six holes, four ovens, and four fire boxes. It is 1.92 by 4.72
meters in size and possesses the necessary appurtenances for
both plain and fancy cooking; steam heated, metal tea, coffee, hot
water, and milk urns, are also conveniently placed here, the first
three having«a capacity of 40 liters each and the one for hot milk
a capacity of 15 liters ; another very necessary appliance found
here is the steam table, the cooked food is placed in copper con-
tainers and deposited on this table until such time as it is trans-
ferred to the food trucks to be wheeled to the pavilions, when
it is placed in other copper containers having hot water compart-
ments; the containers with their contents are placed on the truck
thus insuring the food's being kept warm. There are also a
copper steam rice cooker having a capacity, of 150 liters ; a steam
soup kettle with a capacity of approximately 150 liters ; two steanl
cereal and vegetable cookers holding 35 liters each, and two earth-
enware steam vegetable cookers with a capacity of 24 liters each,
all of which add materially to efficiency and despatch in the cook-
ing and serving of food; copper pit)es carry the steam from all
these cookers to the outside of the building. A large porcelain
refrigerator is kept here to supply cold water and for the storage
of smaller quantities of edibles. In addition this room contains
the necessary serving tables, sinks, and other equipment of the
In the side rooms are to be found kitchen utensils and sup-
plies among which are an electric ice cream freezer having a
capacity of about 35 liters, an telectric bread cutter, a meat chop-
per and a potato parer. In a small room adjoining the refrigerat-
ing plant is located the dynamo which operates the brine pumps
for the cold storage plant. The main refrigerator is 2.70
by 3.18 meters in size and the cold store room adjoining is the
same size. In this room are kept the perishable food sup^plies.
The free dispensary, situated to the southeast of the hospital
is an attractive two-story building 13.25 by 24 meters in size.
It was one of the last of the present group of buildings to be
completed, and was occupied on April 20, 1911. One has only
to witness the number of persons passing in and out of it, how-
ever, to realize what an important link it constitutes in the chain
On the lower floor are to be found, on the East side, two
medical clinic rooms, a sterilizing room fitted with everything
necessary for preparing the necessary dressings for the out
patient obstetrical department, and a toilet room containing four
flush closets of latest design. The floor is of hexagonal white
tile. On the west side are located two surgical clinic rooms, a
dressing room and toilet with accommodations similar to the one
described above. The clinic rooms are provided with sinks and
lockers. The balance of the floor is occupied by the pharmacy
and a waiting room. The pharmacy is very hand'somely fitted
up with polished native wood shelves and medicine cases, the
bottles are provided with white enameled name plates upon which
the names are printed in black lettering and are shelved accord-
ing to size thus giving a very pleasing appearance. An average
of about 200 prescriptions and 85 ward stock bottles are filled
daily at the present time and the number is increasing constantly;
B ! 1
GlROUnd tloor plan
STUDENTS CLINICAL LABORATORY
UPPEIR PART OF
EYE, EAR, NOSE
FREE CLINIC 11
SCALE /lOO M.
Second floor plan
On August 7, a total of 278 prescriptions and 85 stock bottles
'were filled; this amount of work taxes the working capacity of
the pharmacy and of the force in charge.
The entire second floor is given up to laboratory work. In a
room at one end the greater part of the clinical microscopy of
the hospital is being done by an employee of the Bureau of
Science, the balance of the floor being used as a class room for
the College of Medicine and Surgery, where the students are
given practical instruction in laboratory methods and technique.
The floor is equipped with modem laboratory apparatus.
The building is equipped with gas, electricity, steam, and hot
and cold water.
The following extract from the report of the Superintendent
throws additional light on the work of the free dispensary :
The out patient or dispensary work at this hospital divides itself into
three divisions, first the calls of Government^ beneficiaries, second the
calls of private patients, third the patrons of the free dispensary.
A word concerning the third class. The patrons of the free dispensary
and clinic have been increasing daily. Up to January 1, 1911, a free
dispensary and clinic were conducted at St. Paul's Hospital by the staff
of the Medical College. After January 1, 1911, this clinic was transferred
to the Philippine General Hospital and was divided into three sections.
(1) The medical, tuberculosis, obstetrical, skin, children, neurology, and
genito-urinary clinics, 'with from 50 to 150 patients daily, were held in
the new dispensary and the sick came to the hospital proper to get their
medicines at the pharmacy, which until May 1911, was conducted in a
room in the operating pavilion. (2) The eye, ear, nose, and throat clinic,
with 30 to 50 patients daily, was conducted on the lower floor of the operat-
ing pavilion; and (3) the surgical clinic was, until June 16th, held in the
dressing, sterilizing, and waiting rooms of the surgical pavilion. This third
section was removed to the dispensary about the middle of June.
Numerous important problems presented themselves in conducting this
out dispensary work. The question of bottles; the hours which the busy
physicians of the hospital could devote to this important work; the char-
acter of the work, it being necessary to examine, diagnose, treat, and
prescribe for the many patients within a reasonable period, which demanded
the exercise of the highest skill and diagnostic ability; then the question
of the vast quantities of medicine to supply 15,000 free patients annually,
and the personnel to fill the prescriptions; questions as to whether the
persons applying for free treatment were actually unable to pay;
whether a small fee should not be charged for dressings and medicines;
and how far charity should extend in providing those known to be in actual
need with spectacles, crutches, trusses, wooden legs, glass eyes, and the
like, some of which are yet to-be-worked-out problems.
The Dormitory or service building is three stories in height,
the first two being constructed of reinforced concrete and the
third of wood. Red tiles made locally of cement are used for
the roof. The building is located in the rear of the hospital
grounds and accommodates the druggist, attendants, male pupil
nurses, clerks, Chinese employees, and servants. It will house
160 persons comfortably. Modern plumbing has been installed,
ample locker rooms provided, and other conveniences supplied
which make it admirably well suited for the purpose for which
it is intended.
NURSES' HOME AND NURSES.
The nurses' home is one of the most attractive buildings of the
entire group, being well proportioned both inside and out. It
is situated to the northeast of the Administration Building and
is a reinforced concrete structure, as are all of the pavilions,
21.2 by 30.5 meters in size, with a cement tile roof and concrete
The home was not completed when the hospital was opened^:
thus making it necessary for the nurses to occupy one of the
pavilions in the hospital proper. After much delay it was finally
occupied on March 20, 1911, and has proved to be admirably well
suited to the needs of the nurses.
There are six sleeping rooms on the first floor and twelve on
the second. The rooms are large and with few exceptions open
on spacious porches. Each room contains one, the larger rooms
two, white enameled single beds with five-inch rubber tired
wheels, a native hardwood dresser, a chiffonier, a writing desk,
a bookcase, chairs, and bamboo tea tables. All are fitted with
good-sized wardrobes, in the doors of which are built full length
mirrors. The rooms are splendidly lighted having three electric
lights each with ornamental fixtures and they all have electric
fan attachments. The floors are built flush with those of the
piazzas making it a very easy matter to roll the beds out on the
piazza, in order that those who so desire may sleep there; it
is needless to say that the majority of the nurses take advantage
of this opportunity as it is not only comfortable but very con-
ducive to good health. The rooms are fitted with louver doors
which admit the maximum amount of air. In addition to these
they have solid wooden doors and solid transoms which may be
used to shut out sound from the corridors ; the nurses who neces-
sarily have to sleep in the daytime find this a great convenience.
Double doors open on the piazzas.
The dining room on the first floor seats about thirty persons
comfortably, at three large tables. The floor is laid with a
native hardwood. Beside the tables the room contains a largd
attractive sideboard, a buffet table, and chairs to match, all made
from one of the native hardwoods resembling mahogany. It is
IRST FLOOR PLAN
SECOND F LOOR PLAN
Third floor plan
C R R I DOR
CLQ - CLO.
BED ROOM '"°i'r^ir^ BED ROOM BED ROOM BED ROOM
Second floor plan
BED ROOM I BtD ROOM I BED ROOM I BED ROOl
C O R R I DOR
RECEPTION ROOM ■ BED ROOM
V E R A N D A
Scale /lOo m
Ground floor plan
well lighted by two triangular electric light chandeliers of
modem design and two wall lights with ornamental brackets.
Two sets of double doors open on the piazza. The tables are
supplied with electric call bells.
The reception room is large, airy, and tastefully furnished;
has two double doors opening on the piazza, an arch opening into
the main entrance, and two single doors opening into the corridor.
It is well supplied with chairs, tables, and bookcases and con-
tains a handsome couch. The furniture matches that in the other
parts of the home. This room also contains a Concord Cabinet
Grand piano, which it is needless to say is a source of much
pleasure to the nurses. The lighting scheme here is in accord
with that in the dining room.
The equipment of the toilet rooms, of which there is one on
each floor, is the most modern that could be purchased. The
floors are laid with white hexagonal tile, which makes them not
only pleasing to the eye, but sanitary as well. Each room con-
tains two showers and one tub bath, three wash basins, two
closets and one slop hopper, all of these appliances are made of
porcelain and are thoroughly sanitary in construction. Both
rooms are plumbed for hot and cold water and are electrically
Each floor has a room for clean linen and drugs, as well as a
soiled linen room. The second floor is also provided with a large
lounging or sewing room.
Marble steps were used in the construction of the stairway
, connecting the first and second floors.
All doors opening on the verandas are provided with trans-
lucent shell panels thus giving the maximum amount of light
On the third story four roof gardens have been constructed,
making an ideal location in which to enjoy the balmy evenings.
The kitchen and pantry are large and well ventilated and have
hexagonal white tile floors. The pantry is well provided with
shelves for dishes and drawers for linen, silver, and trays. The
kitchen, pantry, and a section of the veranda are screened to
prevent the entrance of flies and insects. A Leonard porcelam
refrigerator, connected with the rain water dram, is kept on the
veranda. Both rooms have hot and cold water plumbmg and
sinks with drip boards. A large army range is used to do the
nurses' cooking. A toilet for the servants constitutes a part of
the first floor equipment.
The front doors are made of scroll work iron and have a
brass monogram of the letters N. H. attached.
The linen for the home was made to order in Japan and is
stamped with the monogram N. H. as is the solid silver service.
The nurses have their private telephone line in the building, as
well as the hospital line, which may also be used for outside
service. The housekeeper answers all calls and pays all bills for
the nurses. Wednesday and Sunday evenings are termed "guest
nights" though friends may be invited to dinner any evening.
Dancing is permitted until 11 p. m. Tea is served from 3 to 5
p. m. for the nurses going on or coming off duty. The day is
divided into three shifts of eight hours, viz, 7 a. m. to 3 p. m.,
3 p. m. to 11 p. m. and 11 p. m. to 7 a. m. The nurses are left
on the same duty for one month and unless there exists special
reasons for changing, they are left in the same department inde-
finitely, thus giving a nurse the opportunity to do the class of
work she is especially interested in. The nurses of the Philip-
pine General Hospital are given more privileges and shown more
consideration in nearly every way than are those in the vast
majority of hospitals. The reader must not infer from these
statements that discipline is lax for good discipline is one of the
strongest assets of the institution.
The Filipina nurses as a whole are a grand success. They are
quiet, gentle, patient, and are making rapid progress along the
line of proficiency. One very frequently hears patients make
the statement that they would as soon have a good Filipina nurse
care for them as an American. The Filipina nurses are living
in dormitories a short distance from the hospital. Eventually
they will have a home of their own on the hospital grounds. A
photograph of the six girls constituting the first class graduated
from the hospital will be found on another page and with their
native costumes they make a very attractive group.
The male pupil nurses are rapidly acquiring the knowledge
necessary to make them successful nurses and their ministrations
will in the future undoubtedly prove to be a blessing to many of
the sick of the Islands who have suffered heretofore without the
care of either doctor or nurse.
American nurses will have to be employed to act as head nurses
for some time to come, but with the efficient class of nurses
coming from the States and the good-sized classes of proficient
native nurses, which will be graduated annually from this time
on, the nursing outlook for the Philippines is most promising.
When the hospital was occupied September 2, 1910, the nursing
force consisted of 15 American and 56 pupil nurses. On June
30, 1911, the nursing staff consisted of 18 American females, 5
American males, 69 female and 38 male pupil nurses and 3
graduate Filipina nurses.
All other pay
MEDICAL AND SURGICAL CASES.
Class B wards
Private rooms with bath
Class B wards _ _
Private rooms with two beds each person.
Private rooms with one bed
SPECIAL RATES FOR CHILDREN.
Well children up to 6 years of age kept in children's nursery
Sick children up to 14 years of age.
FEES FOR SPECIAL NURSES.
(Note. The hospital does not obligate itself to furnish special nurses
but will do so when practicable, if they are desired.)
LABORATORY FEES (Bureau of Science) .
Other examinations. (Special list of prices furnished when re-
All fees for biological and chemical examinations must be paid at
the office. No officer or employee of the Bureau of Science is
allowed to accept private fees for laboratory work.
Electrical treatments will be administered onlx upon physicians'
prescriptions, and charges will be made at the f ollowmg rates.
High frequency, ultraviolet, de Arsonivalization, Fulguration and
Cystocopic, sigmoidoscopies and similar examinations and treat-
AU fees for electrical treatment are payableto the Cashier at the
office. Under no circumstances will the operator be allowed to
Medicines and articles of diet not on regular lists will be charged
On account of the fact that the hospital has been in operation
for so short a period of time statistics would not be representative.
No attempt will be made, therefore, to go into detail on this
Unless otherwise stated reports given cover the period from
September 1, 1910, to June 30, 1911.
Six ward floors of 50 beds each 300
Three private floors of 42 beds each 126
Filipina Maternity, 30 adults, 20 sick children 50
This computation does not take into account the number of
new-born infants on either floor of the maternity pavilion. More
than fifty patients can be accommodated on each of the six ward
floors without undue crowding.
The hospital offers an excellent clinical field for medical
students as 200 beds are always available for teaching purposes
and material may be selected from approximately another 100
beds if it is desired to do so.
Total number of physicians, nurses, and employees in the hos-
pital, including male and female training schools, on September
22, 1911, 352.
Expenditures and obligations.
Total appropriations for buildings and improve-
ments to grounds ¥=1,080,899.09
Expended for equipment to June 30, 1911 153,447.25
Estimated outstanding obligations for equip-
ment June 30, 1911 50,000.00
Cost per bed.
Cost' of buildings and equipment ^1,284,346.34
Total number of beds 476.00
Cost per bed -. 2,698.20
Original appropriation, Act 1954 P780,000.00
Transfer from Medical School appropriation,
Act 1954 10,000.00
Appropriation for completion and equipment.
Act 1902 203,581.29
Transfer from appropriation for plumbing,
Act 1954 30,375.28
Transfer of funds authorized by the Secretary
of the Interior, December 28, 1910 56,942.52
BUILDING EXPENDITURES TO JUNE 30, 1911.
Additions and alterations '?48,737.21
Ambulance garage 9,672.35
Construction main buildings 636,514.34
Drafting and blue prints 32,772.26
Foundations .......'. 1,284.99
Filling _ 38,181.72
Inspection of work 5,105.80
Installation of power, heating, light, and cable.. 63,917.66
Sewer system 11,234.70
September 1, 1910, to June 30, 1911.
Salaries and wages ?63,569.38
Commutation of subsistence 5,323.13
Subsistence supplies 67,197.20
Telephone, rent 868.79
Coal, oil, gas, and steam 4,782.66
Laundry, hospital 9,604.35
Laundry allowance 1,617.42
Medicines, medical and surgical supplies 18,395.62
Maintenance, grounds 3,802.72
Office supplies 1,138.90
Miscellaneous supplies 13,618.94
Salaries, laundry allowances, and subsistence of
pupil nurses 30,221.20
Hospital equipment 153,447.25
Improvement on building 572.39
COST OF SUBSISTENCE.
Average cost per day.
per person per
March -- ---
The following table illustrates the steady increase in the num-
ber of patients at the end of each month :
September 30, 1910 43
October 31, 1910 58
November 30, 1910 60
December 31, 1910 .- 65
January 31, 1911 132
February 28, 1911 214
March 31, 1911 204
April 30, 1911 215
May 31, 1911 291
June 30, 1911 284 .
July 31, 1911 324
August 31, 1911 353
Smallest number of patients in hospital at one time
September 2, 1910 (opening day) 10
Largest number of patients in hospial at one time
September 6, 1911 354
Patients admitted by Bureaus September 3, 1910, to June SO, 1911.
Coast and Geodetic Survey
Municipal Board _ -
Patients admitted from September 3, 1910, to June 30, 1911.
Classification by residence.
City of Manila
Albey _ _
Ambos Camarines ___ .
Leyte __ ____ _
Negros Occidental ___
Neeros Oriental . ,.
Samar _ _.
Nueva Vizcaya _ _ _
Patients admitted monthly by nationalities.
From September 3, 1910, to June 30, 1911, inclusive.
Patients admitted September 3, 1910, to June SO, inclusive
ClasBification by ag:es.
Under 30 days .
30 days to 1 year
1 to2 years
2 to 5 years-,
10 to 15 years
15 to 20 years
20 to 25 years-.
26 to 30 years ---
30 to 40 years
40 to 50 years..
60 to 60 years .-.
60 to 70 years
70 to 80 years
80to 90 years
90 to 100 years.
Patients admitted monthly according to service and sex from September
3, 1910, to June 30, 1911, inclusive.
Male - _ ,
Monthly report of the Clinical Division for October, 1911.
Total number of admissions 638
Total number of discharges (including transfers, etc.).. 626
Total number of births 27
Total number of deaths 38
Total hospital days 9265i
Average hospital days 14|
Admissions) ^em^aie.":;." 229 } '^^^al ~^
Eye, ear, nose, etc 92
The Electro-Therapeutic Department.
The X-ray department was opened for use January 10, 1911.
were made as follows :
June. ___ . _ , _
Urine examinations : 2,852
Feces examinations 1,866
Sputum examinations 586
Blood examinations 274
Pus examinatipns 18
Stomach contents examined 14
Serums and cultures examined ^ 16
Exudations, (acne, ear, etc.) examined) 28
Prescriptions and ward orders were filled by months as follows:
May --- -
July and August statietics are for the Civil Hospital.
Largest jiumber of prescriptioni and ward orders filled in one day, 322.
Annual report for the fiscal year, 1911. July, 1, 1910, to June SO, 1911.
Number of patients:
First visit _ _
More than one visit
Males • _
Number of patients:
Males ... '-1!.^.-'.''"!'"
Eye, ear, nose and throat clinic
Genito-urinary clinic . ...
Number of prescriptions filled
Note.— Reports for July and Aueust are Civil Hospital statistics.
Monthly report of free dispensary, for the month of October, 1911,
Number of patients:
First visit 2,529
More than one visit 3,791
Medical clinic 1,890
Surgical clinic 1,948
Children clinic 338
Skin clinic 254
Obstetrical clinic 47
Tuberculosis clinic 461
Eye, ear, nose, and throat clinic 1,260
Neurology clinic 54
Genito-urinary clinic , 68
Number of prescriptions filled 6,146
MEDICAL CONSULTATION OFFICE. ADMINISTRATION PAVILION.
PLATE XI v.
VESTIBULE, ADMINISTRATION PAVILION.
MAIN OFFICE, ADMINISTRATION PAVILION.
PLATK X\ .
COURT FACING FRONT OF ADMINISTRATION PAVILION.
COURT FACING REAR OF ADMINISTRATION PAVILION.
GARAGE AND AMBULANCES.
yy^^^.. , ...rr?!35?5
!»^\ .-?•■'-' ^ ■?' -'•s :«'!.::
PLATE X\ 111.
COURT AND CORRIDORS.
COURTYARD BETWEEN PAVILIONS.
ACACIA TREES IN HOSPITAL GROUNDS.
OPEN COURT AT REAR OF OPERATING PAVILION.
CORRIDOR, OPERATING PAVILION.
ONE OF THE STERILIZING ROOMS.
ONE OF THE OPERATING AMPHITHEATERS, SHOWING PORTION OF ZEISS
NINETEEN BABIES LESS THAN TEN DAYS OLD. THREE PAIRS TWINS.
PHILIPPINE GENERAL HOSPITAL, 1911.
REAR VIEW OF KITCHEN.
r -; ' ^^.-- r— ---_■ -f" ■ ' - «^J
INTERIOR OF KITCHEN.
Showing patients awaiting treatment.
ROOM IN THE NURSES' HOME.
PIAZZA, NURSES' HOME.
PART OF DINING ROOM, NURSES' HOME.
RECEPTION ROOM, NURSES' HOME.
'" — --'•^..
PRELIMINARY CLASS. ADMITTED OCTOBER 1, 1911.
chief nurse and female pupil nurses. four graduates, front row.
CHIEF NURSE AND MALE PUPIL NURSES.
FIRST GRADUATING CLASS.
3 1924 063 266 534